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Revitalizing brain perfusion: Unveiling advancements through rhythm control strategies in atrial fibrillation—A systematic review

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Title: Revitalizing brain perfusion: Unveiling advancements through rhythm control strategies in atrial fibrillation—A systematic review
Authors: Shinta Dewi Rasti, Adra Achirultan Ramainaldo Sugiarto, Audia Putri Amalia Nuryandi, Militanisa Zamzara Arvianti, Romadhana Trisnha Yomara, Jeffri Nagasastra, Rerdin Julario, Rosi Amrilla Fagi, Diah Mustika Hesti Windrati
Source: J Arrhythm
Journal of Arrhythmia, Vol 40, Iss 3, Pp 411-422 (2024)
Publisher Information: Wiley, 2024.
Publication Year: 2024
Subject Terms: Clinical Review, 03 medical and health sciences, rhythm control, 0302 clinical medicine, cardioversion, brain perfusion, RC666-701, cerebral blood flow, Diseases of the circulatory (Cardiovascular) system, atrial fibrillation, 3. Good health
Description: BackgroundRecent evidence suggests an elevated risk of cognitive impairment and dementia in individuals with atrial fibrillation (AF), irrespective of stroke occurrence. AF, known to reduce brain perfusion, particularly through silent cerebral ischemia, underscores the intricate relationship between cardiac and cerebral health. The heart plays a crucial role in supporting normal brain function, and rhythm control, a standard AF treatment, has demonstrated enhancements in brain perfusion. This systematic review aimed to examine published data concerning the influence of rhythm control on brain perfusion in patients with atrial fibrillation.MethodsA systematic search for relevant studies was carried out in Scopus, PubMed, Cochrane Reviews, ProQuest, and EBSCOhost, spanning from their inception until April 30, 2023. Studies that specifically examined brain perfusion following any form of rhythm control in atrial fibrillation were included in the review.ResultsThe review encompassed 10 studies involving 436 participants. Among these, six utilized electrical cardioversion for rhythm control. The majority (8 out of 10) demonstrated that restoring sinus rhythm markedly enhances brain perfusion. In one of the two remaining studies, notable improvement was observed specifically in a region closely linked to cognition. Additionally, both studies reporting data on the Mini‐Mental State Examination (MMSE) showed a consistent and significant increase in scores following rhythm control.ConclusionSuccessful rhythm control in AF emerges as a significant contributor to enhanced brain perfusion, suggesting a potential therapeutic avenue for reducing cognitive impairment incidence. However, further validation through larger prospective studies and randomized trials is warranted.
Document Type: Article
Other literature type
Language: English
ISSN: 1883-2148
1880-4276
DOI: 10.1002/joa3.13056
Access URL: https://pubmed.ncbi.nlm.nih.gov/38939785
https://doaj.org/article/fa75264e91c847709397b9dca4bf68ec
Rights: CC BY NC
Accession Number: edsair.doi.dedup.....6a92a907a24ef3bfc2f77ef0b00f1404
Database: OpenAIRE
Description
Abstract:BackgroundRecent evidence suggests an elevated risk of cognitive impairment and dementia in individuals with atrial fibrillation (AF), irrespective of stroke occurrence. AF, known to reduce brain perfusion, particularly through silent cerebral ischemia, underscores the intricate relationship between cardiac and cerebral health. The heart plays a crucial role in supporting normal brain function, and rhythm control, a standard AF treatment, has demonstrated enhancements in brain perfusion. This systematic review aimed to examine published data concerning the influence of rhythm control on brain perfusion in patients with atrial fibrillation.MethodsA systematic search for relevant studies was carried out in Scopus, PubMed, Cochrane Reviews, ProQuest, and EBSCOhost, spanning from their inception until April 30, 2023. Studies that specifically examined brain perfusion following any form of rhythm control in atrial fibrillation were included in the review.ResultsThe review encompassed 10 studies involving 436 participants. Among these, six utilized electrical cardioversion for rhythm control. The majority (8 out of 10) demonstrated that restoring sinus rhythm markedly enhances brain perfusion. In one of the two remaining studies, notable improvement was observed specifically in a region closely linked to cognition. Additionally, both studies reporting data on the Mini‐Mental State Examination (MMSE) showed a consistent and significant increase in scores following rhythm control.ConclusionSuccessful rhythm control in AF emerges as a significant contributor to enhanced brain perfusion, suggesting a potential therapeutic avenue for reducing cognitive impairment incidence. However, further validation through larger prospective studies and randomized trials is warranted.
ISSN:18832148
18804276
DOI:10.1002/joa3.13056